Sexual functioning in patients undergoing bone marrow transplantation: a longitudinal study.

Patients undergoing bone marrow transplantation (BMT) reported numerous sexual difficulties pretransplantation and at 1- and 3-years post transplantation. The most commonly reported problems pretransplant were a lack of sexual interest for men and self-perceived unattractiveness for women. At year 1, men reported more concern about physical attractiveness and increased problems with erection, ejaculation and orgasm. Women reported more sexual problems across all categories. At year 3, difficulties for men remained relatively consistent or decreased compared to year 1 with the exception of an increased concern about physical appearance. At year 3, women reported increased sexual interest; concerns about body appearance, vaginal dryness, painful intercourse and orgasm remained higher than at baseline, although all had decreased from year 1. Half of patients at all time points reported no discussion of sexuality with their health care provider. Baseline level of depression was significantly and positively related to sexual functioning at year 3 post transplant. These results suggest that sexual problems are significant for BMT survivors and that treatment of depression and health-care-provider education are possible interventional targets for improving sexual function and quality of life following BMT.

Apraclonidine and argon laser trabeculoplasty.

Sixty patients with medically uncontrolled open-angle glaucoma (intraocular pressure greater than 21 mm Hg) were randomly assigned to one of two treatment regimens with apraclonidine before undergoing 360-degree argon laser trabeculoplasty. One drop of apraclonidine 1% was instilled one hour before and immediately after laser treatment in 30 eyes or apraclonidine was delivered only after trabeculoplasty in 30 eyes. Intraocular pressure before laser treatment, number of antiglaucoma medications, and the laser treatment settings were comparable between the two groups. The mean and percent change in intraocular pressures were similar in both treatment groups one and two hours after trabeculoplasty. One drop of apraclonidine 1% instilled immediately after argon laser trabeculoplasty prevented intraocular pressure increase one hour and two hours postoperatively as effectively as its instillation both one hour before and immediately after laser treatment.

Location of port-wine stains and the likelihood of ophthalmic and/or central nervous system complications.

Of 310 patients with port-wine stains, 68% had more than one dermatome involved; 85% had unilateral and 15% had a bilateral distribution of their port-wine stain. At the time of examination, 8% of all patients with trigeminal port-wine stains had evidence of eye and/or central nervous system (CNS) involvement. Extensive involvement, with port-wine stain over the trunk and extremities as well as the head and neck, was observed in 12%. Patients who did not have port-wine stains on the areas served by branches V1 and V2 of the trigeminal nerve had no signs or symptoms of eye and/or CNS involvement. Port-wine stains of the eyelids, bilateral distribution of the birthmark, and unilateral port-wine stains involving all three branches of the trigeminal nerve were associated with a significantly higher likelihood of having eye and/or CNS complications. Twenty-four percent of those with bilateral trigeminal nerve port-wine stains had eye and/or CNS involvement compared with 6% of those with unilateral lesions. All those who had eye and/or CNS complications had port-wine stain involvement of the eyelids; in 91% both upper and lower eyelids were involved, whereas in 9% only the lower eyelid was involved. None of those with upper eyelid port-wine stains alone had eye and/or CNS complications. In addition, 3 (75%) of the 4 subjects with seizures alone had bilateral port-wine stain involvement. A third group, these with unilateral V1, V2, and V3 port-wine stains, had eye and/or CNS complications in 3 (19%) of 16 subjects.(ABSTRACT TRUNCATED AT 250 WORDS)